Gudex C M
Centre for Health Economics, University of York, UK.
Qual Life Res. 1995 Aug;4(4):359-66. doi: 10.1007/BF01593889.
The objective of this study was to describe the health-related quality of life (HRQOL) of patients on different forms of treatment for endstage renal failure in such a way that the data could be used in a cost-utility analysis of renal failure treatment in Britain. Twenty-four British renal units participated in this study. 997 adult dialysis and transplant patients were randomly selected from these units using the European Dialysis and Transplant (EDTA) Registry Database. The Health Measurement Questionnaire was completed by 705 of the 900 patients who were alive at the time of the survey (response rate of 78%). The HRQOL data were linked with comorbidity data and with clinical data from the EDTA Registry. Compared to the general population, patients with endstage renal failure experienced a lower quality of life. Many factors contributed to this, but uncertainty about the future and lack of energy emerged as key components. Transplant recipients reported better HRQOL than dialysis patients, they reported fewer problems with physical mobility, self-care, social and personal relationships and usual activities. They also experienced significantly less distress, while dialysis patients reported problems with depression, anxiety, pain and uncertainty about the future. These differences remained after controlling for age and comorbidity.
本研究的目的是以一种可用于英国肾衰竭治疗成本效用分析的方式,描述接受不同形式终末期肾衰竭治疗患者的健康相关生活质量(HRQOL)。24个英国肾脏单位参与了本研究。利用欧洲透析与移植(EDTA)登记数据库,从这些单位中随机选取了997名成年透析和移植患者。在调查时存活的900名患者中有705名完成了健康测量问卷(应答率为78%)。HRQOL数据与合并症数据以及EDTA登记处的临床数据相关联。与普通人群相比,终末期肾衰竭患者的生活质量较低。造成这种情况的因素有很多,但对未来的不确定性和缺乏精力成为关键因素。移植受者报告的HRQOL比透析患者更好,他们在身体活动能力、自我护理、社会和人际关系以及日常活动方面报告的问题更少。他们经历的痛苦也明显更少,而透析患者报告了抑郁、焦虑、疼痛以及对未来的不确定性等问题。在控制了年龄和合并症后,这些差异仍然存在。